=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972613008
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATURAL HEALTH CENTER SC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 10/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8334 W BLUEMOUND RD
-----------------------------------------------------
City | WAUWATOSA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53213-3314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-258-6160
-----------------------------------------------------
Fax | 414-258-6175
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8334 W BLUEMOUND RD
-----------------------------------------------------
City | WAUWATOSA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53213-3314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-258-6160
-----------------------------------------------------
Fax | 414-258-6175
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. HERBERT E KUEHNEMANN
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 414-258-6160
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2378
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------